In Brief

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Evidence of Program Model Effectiveness

This program model does not meet the criteria established by the Department of Health and Human Services (DHHS) for an “evidence-based early childhood home visiting service delivery model” for the general population or for tribal populations.

Program Model Description

Triple P–Positive Parenting Program® (Triple P) is a parenting and family support system designed to prevent and treat behavioral and emotional problems in children from birth through their teenage years. Specialized interventions target certain subgroups, including children with a disability and indigenous families. To meet the needs of different families and implementing agencies, the Triple P system uses five levels of increasing intensity, a range of delivery methods (such as one-on-one consultations in the home or group seminars), and staff from multiple disciplines (including paraprofessionals, counselors, and nurses). The intensity and length of services also varies across levels. For example, Primary Care Triple P (Level 3) includes approximately four individual consultations of 15 to 30 minutes over one to two months, and Enhanced Triple P (Level 5) includes approximately eight individualized sessions, each lasting 60 to 90 minutes.

The HomVEE review is based on Triple P interventions where home visiting was the primary service delivery mechanism with prenatal parents or families with children birth to age 5 (Triple P–Home Visiting).

This report also includes reviews of one Triple P-Home Visiting component (Child Management Training) and a specialized Triple P-Home Visiting intervention (Stepping Stones Triple P) for children with a disability; both are considered Level 4 Triple P interventions. During Child Management Training, therapists meet with parents in the home and explain how parents can help teach their children new behaviors using a six-step procedure of descriptive praise and contingent consequences. In this component, a therapist provides verbal and written instruction, lecture presentations, and modeling behavior in an effort to teach parents about a sequence of steps intended to modify their child’s behavior. Then, they observe parent-child and parent-parent interactions and provide verbal feedback and written enrichment materials. (As the model was being developed, this component was originally called Instructions + Feedback.) Stepping Stones is a variant of Triple P-Home Visiting intended specifically for parents of children with disabilities. It provides assessment of parenting strategies and then instruction and support that aim to promote child competencies in social and language skills, emotional skills, independence, and problem solving.

Note: For this model, several Triple P studies compared various components of the program model, sometimes in a single-case design format with multiple phases. For screening and reviewing studies, we focused on those with a contrast between Triple P—Home Visiting and a non-Triple P condition.

*The table includes results from single-case design studies. However, these results are not factored into whether a model meets the DHHS criteria unless additional criteria are also met. Please read the DHHScriteria for evidence-based program models for more information.

This table summarizes the effects found in research across outcome domains. Outcomes with a favorable impact are
listed in green and outcomes with an unfavorable or ambiguous impact are listed in red. Outcomes that have high attrition or lack of baseline equivalence
are excluded from this report. The Summary of Findings table reports only findings with a high or moderate rating.

Favorable Impact: A statistically significant impact on an outcome measure in a direction
that is beneficial for children and parents. This impact could statistically be positive or negative, and is determined “favorable” based on the end
result. For example, a favorable impact could be an increase in children’s vocabulary or daily reading to children by parents, or a reduction in
harsh parenting practices or maternal depression.

Unfavorable or Ambiguous Impact: A statistically significant impact on an outcome measure in
a direction that may indicate potential harm to children and/or parents. This impact could statistically be positive or negative, and is determined
“unfavorable or ambiguous” based on the end result. NOTE: While some outcomes are clearly unfavorable, for other outcomes it is not as clear which
direction is desirable. For example, an increase in children’s behavior problems is clearly unfavorable, while an increase in number of days mothers are
hospitalized is more ambiguous. This may be viewed as an unfavorable impact because it indicates that mothers have more health problems, but it could
also indicate that mothers have increased access to needed health care due to their participation in a home visiting program.

Criteria Established by the Department of Health and Human Services

Information Based on Comprehensive Review of All High- and Moderate-Impact Studies for this Model

High- or moderate-quality impact study?

No

Yes

Yes

Across high- or moderate-quality studies, favorable impacts in…

at least two outcome domains within one sample

OR

the same domain for at least two non-overlapping samples?

No

No

No

Favorable impacts on full sample?

NA

Yes

No

Any favorable impacts on outcome measures sustained at least 12 months after program enrollment?a

No

No

No

One or more favorable, statistically significant impact reported in a peer-reviewed journal?a

No

Yes

No

NA = not applicable.

aThis information is reported for all program models, but the requirements for sustained findings and inclusion in a peer-reviewed journal only apply to models for which all findings are from randomized controlled trials.